There is no easy way to tell someone you’re worried about them, especially when it’s their weight gain you’re worried about.

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I’ve been asked several times over the years for advice about how to approach a spouse or a friend about it.

“He complains that he’s fat, but he refuses to get off the couch when I suggest we go for a walk. How do I get him to do something about it?”

“She’s always putting herself down and saying she wants to change, but she makes self-destructive decisions. Do I speak up?”

“What can I do to help? I’m afraid I’ll lose him to heart disease at a young age.”

I’m sure my friends and family have had similar conversations about me throughout my weight changes. Actually, I know they have.

It’s not just an expanding waistline that’s cause for concern, either. I remember being prodded about how much I was eating when I slimmed down to 115-120 pounds around age 21.

I ordered the same thing every day at the bar/grill where I worked – a side salad with a piece of grilled chicken on top, honey mustard dressing on the side. A manager said in the break room, “Are you eating enough? I’m concerned about you.”

Later, when I waited on a former college classmate after ballooning up to a size 18, she didn’t recognize me at first. Once she did, and when I told her I went through a breakup with my long-term boyfriend, she looked at me incredulously and said, “Don’t let him win, honey!”

As if gaining weight “let” my ex “win,” because it’s all about losing and gaining and winning and losing, right?

It’s easier for me to tell you what not to say than what to say. Want more examples? Here are a few, all said to me at different stages of my life:

“You don’t REALLY want seconds, do you?”

“You’d be prettier if you lost weight.”

“You don’t need those” (grabbing the bag of M&M’s I put on the conveyor belt and putting them back on the shelf).

Even if you approach the topic with care, it’s going to hurt, at least a little, but it’s probably not news. People who are overweight or obese are aware they’re overweight or obese and know they should do something about it.

They might be in denial, they might not want to face it, they might not think they have what it takes, they might be afraid of failure, or they might be A-OK with it.

For whatever reason, if someone isn’t willing to change their habits, they’re not going to, and guilting or shaming them into doing it is only going to make things worse in the long run.

No matter what you say, I can tell you that it helps to speak from the heart and tell your loved one you just want them to be healthy and happy. Assure them that you’ll continue to love and support them at any size.

A lot of people who struggle with their weight, at both ends of the spectrum, tend to equate their weight with their self-worth and lovability. So, if you push them away when they gain and pull them closer when they lose, you’re further reinforcing that damaging association.

When expressing your concern, make sure you keep it separate from your overall opinion of them and feelings for them, and emphasize that it’s out of concern for their health, not judgment about their looks.

Meredith Holt is a Forum features reporter who writes a twice-monthly column on body image, weight loss (and gain), health and fitness. Her topics of interest include mental health, relationships and women's issues. She also does page design and copy editing, which she did for six years prior to joining the features staff in March 2012.